Evaluating “virtual visit” effectiveness

Working on the front line of COVID-19 treatment, health care workers are at increased risk for contracting the virus. And providers treating the head and neck are at an even greater risk of exposure to saliva, mucus, and other fluids that hold a high concentration of the virus. To protect these workers, non-essential patient care has been minimized, but plenty of people, including survivors of head and neck cancer, still need to be seen by their physicians. To ensure their continued care, University of Iowa Health Care has implemented virtual follow-up meetings.

Aaron Seaman, PhD, an associate in General Internal Medicine, and Nitin Pagedar, MD, MPH, associate professor of otolaryngology received a one-year, $15,000 grant from the UI’s Holden Comprehensive Cancer Center to research the effectiveness of these telecommunication follow-up meetings. The impact of these meetings has not yet been investigated for head and neck cancer survivorship.

“For head and neck cancer survivors receiving care through UIHC, the COVID-19 risk mitigation processes will include transitioning to a telemedicine format, whereby follow-up encounters involve a phone or video conference between clinician, patients, and possibly caregivers,” Seaman said. “In-person encounters will be scheduled only for urgent or emergent symptoms at the surgical oncologist’s discretion.”

Seaman and colleagues’ previous research suggests the physical and endoscopic examinations are essential for a patient’s reassurance with respect to recurrence. To get a better idea of the possibilities of telemedicine for head and neck cancer survivorship, Seaman and the research team will conduct a qualitative, ethnographic examination. They will analyze in-depth interviews with both patients and providers, record fieldwork observations, and collect all other relevant materials. Specifically, they will look at the transition process to telemedicine care, the challenge and success of the implementation, and patient and provider perceptions of the telemedicine care.

“As a medical anthropologist and health sciences researcher, I find ethnography an ideal methodology for investigating the implementation of care delivery processes,” Seaman said, “It both illuminates the complex interrelations of patient, clinician, and organizational factors that affect care delivery, and accounts for the impact of the broader context and social determinants on that delivery.”

Seaman and Pagedar’s team also includes Nicholas Kendell, MS, an epidemiologist in the Department of Otolaryngology; Heather Reisinger, PhD, associate professor in General Internal Medicine; and Justin Kahler, MHA. Reisinger and Kahler are both in the UI’s Institute for Clinical and Translational Science.


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